Short Wave - Vaccine Distribution: An Equity Challenge

Episode Date: March 2, 2021

The Biden Administration has prioritized speed in its COVID-19 vaccine rollout. Also, a priority...distributing those doses to the populations most impacted by the coronavirus. Host Maddie Sofia talks with NPR science reporter Pien Huang about the challenges underserved communities face in getting the vaccine and the Biden Administration's plans to address vaccine equity in the pandemic.For more reporting on the COVID-19 vaccine, follow Pien on Twitter at @Pien_Huang. You can email the show at [e-mail] pcm.adswizz.com for information about our collection and use of personal data for sponsorship and to manage your podcast sponsorship preferences.NPR Privacy Policy

You're listening to Shortwave from NPR. Maddie Safai here with NPR science reporter Peng Huang. Hi, it ping. Hey, Madi. So last time we had you on the pod, it was back in November, and you were giving us this little sneak peek into how COVID-19 vaccines might be distributed in the U.S. Do you remember that, Ping? Do you remember November?

Wow. That was a really long time ago. I mean, the last time we talked, the country was. was still in a limbo over who would be president. There were no COVID vaccines that had been authorized. And that was just three months ago, but it feels like a whole lifetime. We were so young. We were so young. So, okay, Ping, vaccine distribution, big picture. How's it going? Well, the vaccine rollout got off to a rough start under President Trump. And for President Biden, one of his big priorities has been to try and speed it up.

Yeah. His administration set an early goal for his first hundred days. Here's Biden speaking. on December 8th, 2020, describing his administration's COVID-19 plan. A hundred million shots in the first 100 days. And we'll follow the guidance of science to get the vaccines of those most at risk. And that would have been one million a day. And now the country is actually at 1.4 million shots a day. So we're actually on track to hit and even to surpass that 100 million goal. And now the Biden administration is also focusing on equity in vaccine distribution,

meaning that the population's most impacted in this pandemic should be getting those shots. Here's Dr. Marcellan Nunes Smith, chair of Biden's COVID-19 Health Equity Task Force, at that same event. It is our societal obligation to ensure equitable access to testing, treatments, and vaccines, equitable support for those who are hurting, and equitable pathways to opportunity as we emerge from this crisis and rebuild, including for those most marginalized communities. Right. I mean, we've covered this on the pod before communities of color, specifically black and Latino. You know, some folks in tribal nations, all of these groups have been hit disproportionately hard by the coronavirus.

Yeah. And members of these communities are more likely to become infected and die from the virus. They're at high risk because of factors like age, poor health, job requirements, crowded living conditions and other long-term health care disparities. But there's real concern that in the push for speed, we're not fully addressing the issue of equity and we're leaving our most vulnerable communities behind. So today on the show, getting COVID vaccines out quickly and equitably. This is Shortwave, the Daily Science Podcast from NPR. Okay, Ping, we are talking vaccine equity in the pandemic.

And just a quick note, we are focusing a just. just here in the United States for this episode. So let's start with some top line numbers. Three COVID-19 vaccines have been authorized for emergency use in the U.S., one very recently. How many people have actually been vaccinated so far? Well, since vaccine distribution started in mid-December, around 50 million people have gotten at least one dose of a COVID-19 vaccine. That includes about 25 million people who have gotten two doses, which means they've been fully vaccinated. with either the Pfizer or Moderna vaccines.

And that's some real progress over the past two months. Still, just around 8% of the total U.S. population has been fully vaccinated. So there's still a long way to go. Yeah. I mean, do we have any demographics on who the people who got the vaccine are? Like, do we have any data on race or ethnicity? Well, last week, I spent some time at a CDC conference, which was online, and a bunch of public officials talked about it, including Dr. Marcella Nunes-Smith, who we heard from earlier.

People of color are getting vaccinated at rates below their representation in the general population. We know these challenges reflect longstanding, deeply rooted, systemic realities. But here's the thing. The data that she's talking about is still pretty limited. You know, so far, race and ethnicity data have only been collected for about half of the shots given out. Wow, only half? I mean, that's a little bit frustrating. That's not enough data. Yeah, it's really not. And the Biden administration has pointed this out themselves, and they

acknowledge that it's pretty abysmal. Dr. Rochelle Walensky, she's head of the Centers for Disease Control and Prevention, and she says the problem is coming from a couple different directions. Individuals may choose not to report. It may not be required of or requested by providers. And some providers, as well as jurisdictions, have restrictions on data sharing. So some of these data gaps are due to the fact that we have inconsistent systems or data gathering, which, you know, is something that has been happening quite a bit with this pandemic. Yeah, that's certainly part of it. And there's reasons why people might not want to share their personal information about race and ethnicity, especially people of color. You know,

the federal government has a long history of exploiting and underserving minority communities. Yeah. And that extends to the stay. But now, there are government officials saying that it's up to them to try and convince people that it's important to give their information. Here's New Rav Shah, a health official in the state of Maine. In public health, what gets measured gets managed. And if we measure the right things, then we will manage the right issues. If we measure the wrong things, then the data that we collect that may not bear a resemblance to current present public health challenges is actually what we will end up managing.

Yeah. So early on in vaccine distribution, the only metric that was available was the number of doses is sent out and the number of doses administered, which basically measured speed. Right. And so if the Biden-Harris administration wants to achieve both speed and equity with vaccine distribution, they're going to have to get more comprehensive data on race and ethnicity to get a handle on the problem. Yeah. I mean, I want to talk about what the Biden administration is doing specifically to address

this issue of vaccine equity. But first, let's talk about some of the ways the general rollout has put vulnerable communities at a disadvantage, because that's definitely. happening. Yeah, and to be honest, it's been hard for everyone, including health reporters, to keep up with the changes that are happening daily and weekly with vaccine distribution. I mean, every single state has its own rules about who qualifies and how to sign up. Obviously, that confusion is compounded if the information isn't coming to you in the language you speak, or if you don't have access to computers and email. And even for people who may have read up on

how to book an appointment, it's taken them hours to actually research and book one. So, So if you don't have time to figure that out and if you don't have access to transportation or time off work to get to an appointment, in most places you probably haven't been able to get vaccinated yet. Yeah. I mean, and that's when you know for sure that you want the vaccine. Exactly. And Dr. Christian Ramers, he's a physician and executive at Family Health Centers of San Diego, he points out that people also have questions that are very specific to their own circumstances. And they want those answered before they feel like they can make an informed decision to actually get vaccinated. Here he is speaking to my colleague Yuki Noguchi.

Residency is not just one thing. And in many cases, they're very unique to their own situation. Like, I just got treated for cancer or I'm on a certain medication or I've had an allergy in the past. And those are, you know, questions that'll be answered most likely from talking one-on-one with a medical professional or some other trusted person, which, again, if you're part of an underserved community, is hard to access if you don't have the time to seek out those answers. You know, it would be much easier if the vaccines and the resources were coming directly to you. Right, right. Okay. So Ping, what has the Biden administration specifically announced or done to address vaccine equity? So at that CDC conference, Dr. Marcella Nunes Smith acknowledged that this is a huge issue and it's not going to be easily solved. We must attend to the underlying social and structural drivers as we look ahead to building resilience into our recovery.

What we do believe, though, is that the way we get America vaccinated and the emphasis we place on reaching the hardest hit communities, that's just as important as hitting the goals for the number of people vaccinated. So their strategy to get to those goals basically amounts to increasing a couple different things. Number one, the number of vaccines available. Number two, the number of people giving out vaccines. And number three, the number of places people can get vaccinated. And specific to equity, they've launched a few. few FEMA-supported mass vaccination sites. These are huge operations set up in stadiums and parking lots that are aiming to give out 6,000 shots a day. And they're putting some of these in places that score high on something called the Social Vulnerability Index. Right, which is a CDC measurement of how vulnerable a community is based on social factors like poverty, for example. They've also started sending vaccines directly to community health centers, which serve around 30 million people overall, many whom are rural or belong to minority groups. groups or are low income. And these centers can also offer outreach in different languages and

support for signing up. I mean, are they also leaning on non-medical sites, too? I mean, like, I know working with community leaders and partners can be especially effective. Yeah, well, they're also talking about sending out mobile vaccination trucks to job sites and setting up clinics and local churches and high school gyms and YMCA's, you know, those non-medical sites that you were talking about. And these local community clinics might not be serving thousands of people a day, but they will make the vaccine a lot more available and convenient for people in those communities to get. Gotcha. So the Biden administration is really trying to take a both and approach. They're supporting mass vaccination sites to get a lot of people vaccinated quickly.

And they're also realizing that some people will take more time and more effort to reach. So they're also trying to figure out ways to gather better data and target underserved areas. Okay. So, you know, most of what we've been talking about today, Ping, is how the government is handling this, which I, you know, would argue is the most important facet. But, I mean, is there a sense of individual responsibility here? I know there are a bunch of stories out there about people line jumping or like going into communities outside their own to get vaccines. Yeah, we have all heard those stories. And it's hard to say how much it's happening, but it does make people feel like the system isn't working, you know. And what. bioethicists have said to me is that cheating happens for sure, but it's probably not happening enough to undermine the system overall. I mean, is that all kind of a short-term problem? I mean, there's a huge demand, right, at this point, and not enough supply. But the hope is that, you know, in the coming weeks or months, the situation will change as vaccine manufacturing and distribution

ramp up even further, right? Yeah, and that's been the hope all along. I mean, for weeks now, we've been hearing about a flood of vaccines that will be coming online in the near future, that will make it less cut threat to get a vaccine appointment. And we're not there yet, but there are some promising signs. The government has now ordered a total of 600 million doses of Pfizer and Moderna vaccines to be delivered by the end of July, which is enough to cover 300 million people, and that's more than all the adults in the U.S. Right, right. Plus we've got the newly authorized J&J vaccine, which will eventually make a difference. Right. And getting All these shots in arms is really urgent right now because we're kind of in a race between vaccinations and variants, which means that the more people we protect right now, the fewer people will catch the virus and the fewer chances the virus will have to keep mutating in ways that might make it evade the vaccines and the treatments we've developed.

So that's why it's still super, super important to keep up the other measures that prevent the virus from spreading, double masking, staying physically distant. You know, we're all excited about vaccines, but health experts are saying right now that in the middle of this vaccination campaign is not the time to let up our guard. Okay, Peng Huang, we appreciate you as always. Thank you for coming on the show. Thanks so much, Maddie. Appreciate you too. This episode was produced by Thomas Liu, edited by Viet Le and fact-checked by Rasha O'Ready. The audio engineer for this episode was Gilly Moon. Thanks for listening to Shortwave from NPR. The news is about more than what just happened.

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